Provider Demographics
NPI:1740954577
Name:HOVANDER, PETER (OD)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:HOVANDER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7330 164TH AVE NE STE E150
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-7852
Mailing Address - Country:US
Mailing Address - Phone:425-869-2337
Mailing Address - Fax:
Practice Address - Street 1:7330 164TH AVE NE STE E150
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-7852
Practice Address - Country:US
Practice Address - Phone:425-869-2337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-05
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61169262152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist